Provider Demographics
NPI:1164383386
Name:MATHIES, KRISTA RENEA (LPC)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:RENEA
Last Name:MATHIES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W PARKWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:LIBERAL
Mailing Address - State:KS
Mailing Address - Zip Code:67901-2081
Mailing Address - Country:US
Mailing Address - Phone:620-602-5111
Mailing Address - Fax:855-687-2518
Practice Address - Street 1:11 W PARKWAY BLVD
Practice Address - Street 2:
Practice Address - City:LIBERAL
Practice Address - State:KS
Practice Address - Zip Code:67901-2081
Practice Address - Country:US
Practice Address - Phone:620-604-5111
Practice Address - Fax:855-687-2518
Is Sole Proprietor?:No
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05237101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health